7 AAC 43.1935. Replacement of items

(a) Subject to applicable requirements of 7 AAC 43.1900 - 7 AAC 43.1980, the department will pay for the purchase or rental of replacement durable medical equipment, prosthetics, orthotics, and noncustomized-fabricated orthotics if the

(1) replacement is necessary to replace an item that has been in continuous use by the recipient for the item's reasonable useful lifetime and the department determines that the item is lost or irreparably damaged;

(2) item is not covered by a manufacturer's warranty; and

(3) provider replaces the item with a like item, and if the original item was rented, continues renting the replacement according to 7 AAC 43.1940.

(b) A replacement that is needed because of item wear or a change in the recipient's condition must be supported by current documentation of medical necessity.

(c) If an item is not irreparably damaged, the department may authorize the replacement of the item if the department determines that the cost of replacement would be more cost-effective than repair.

(d) For purposes of this section, useful lifetime is based on when the item is delivered to the recipient, not the age of the item, but in no case less than any useful lifetime of the item established by the manufacturer.

History: Eff. 1/11/2006, Register 177

Authority: AS 47.05.010

AS 47.05.015

AS 47.07.030

AS 47.07.040

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